Intra-uterine u stem pessary



Feb. 15, 1966 R. R. ROBINSON INTRA-UTERINE U STEM PESSARY Filed May 27,1963 IN V EN TOR. Ra/ph R. Robinson United States Patent 3,234,938liNTRA-UTERHNE U STEM PESSARY Ralph R. Robinson, Seattle, Wash. (322Englewood Road, Middleshoro, Ky.) Filed May 27, 1963, Ser. No. 233,326 4Claims. (Cl. 128-130) This invention relates to a pessary for use incorrecting anatomical defects, and has as its primary object theprovision of a pessary of improved construction which may be insertedand worn within the uterine cavity with a minimum of irritation to thewearer thereof and which substantially eliminates cramping and thecomplications associated therewith experienced by wearers of pessariesheretofore utilized.

Another important object of the present invention is the provision of apessary which may be readily inserted within and removed from the uteruswhile at the same time providing means for substantially blocking theFallopian tubes leading to the uterus and preventing any substantialimplantation of ovum in the uterus even if such Fallopian tubes are notcompletely blocked.

Still another important object of the present invention is the provisionof a pessary having a pair of resilient normally arcuate elementscoupled with a shank and being capable of distortion relative to thelatter into a configuration with the elements being disposed straightand parallel so that the pessary may be quickly and easily inserted inand removed from the uterus with the elements in the aforesaidconfiguration notwithstanding the fact that the elements resume theirnormal, arcuate shape when the pessary is fully inserted within theuterus.

Still another object of the present invention is the provision of apessary of the type described which may be carried completely within aninsertion tube prior to the insertion of the pessary within the uterus,whereby the tube may be extended through the cervical opening of theuterus to serve as a guide for the pessary as the same is directed outof the tube and into the uterus.

A further object of the present invention is the provision of a pessaryhaving generally arcuate elements presently convex, outermost surfaceswhich are engageable with the inner wall of the uterus for supportingthe same to maintain the proper shape thereof, notwithstanding the factthat the elements are normally disposed to substantially block theFallopian tubes when the pessary is disposed within the uterus.

A further object of the present invention is the provision of a pessaryof the type described which may be disposed completely within the uterusand cervix thereof and which may be removed therefrom without requiringthe use of additional structure carried by the pessary and projectingoutwardly from the cervix of the uterus as has been heretofore requiredwith conventional pessary devices.

ln the drawing:

FIGURE 1 is an elevational view of a pessary constructed pursuant to theconcepts of the present invention and illustrating the same in aninsertion tool prior to the insertion of the pessary into the uterus;

FIG. 2 is a fragmentary view of the tube inserted into the cervicalopening of the uterus and further illustrating the normal disposition ofthe pessary when the same is disposed within the uterus;

FIG. 3 is a view similar to FIG. 2 and showing the tube removed from thecervical opening of the uterus;

FIG. 4 is an end elevational view of the pessary; and

FIG. 5 is a side elevational view of an instrument for removing thepessary from the uterus.

The pessary which forms the subject of the present invention is broadlydenoted by the numeral and includes "ice a relatively rigid shank l2 anda pair of oppositely looped elements 114 secured to and extendingoutwardly from one end 15 of shank 12 as is clear in FIGS. 2 and 3.Preferably, elements 14 are integral with shank l2 and are formed from anonmetallic, yieldable material such as a suitable plastic. In thisrespect it is conceivable that pessary ill may be molded by any of thewell know molding techniques so that the elements 14, although beingsubstantially resilient, will normally assume the relative dispositionsthereof as illustrated in FIGS. 2 and 3.

Each element 14 includes an elongated, upwardly-extending, slightlyarcuate upwardly-bowed arm 16 and an arcuate extension 13 mergingsmoothly with arm 16 at the extremity of the latter remote from shank 12with arms 16 tangent to extensions 18. It is clear that the radius ofcurvature of each arm 16 is substantially greater than that of thecorresponding extension 13, the radius of curvature of each extension 18being substantially constant throughout the arcuate length of thelatter. The arms 14 converge as end 15 of shank 12 is approached and theextensions 18 project outwardly from arms 14 in opposite directions.

Each extension 1% has an arcuate portion 17 extending downwardlytherefrom and each portion 17 has an arcuate, inwardly-extending length19 thereon. Each length 19 terminates at an extremity of terminus 20which is normally in relatively close proximity to the medial zone ofthe corresponding arm 16. In addition, extremity 20 is disposedintermediate a line extending from end 15 of shank 12 to the majorportion of the corresponding extension 18.

As shown in FIGS. 2 and 3, arms 16 of elements 14 are substantiallydivergent as the same recede from end 15. In addition, the elements 14,as is clear in FIG. 4, are each provided with a pair of opposed, arcuateedges 22 extending throughout the length thereof.

Pessary 16 is to be utilized within the uterine cavity 26 defined by theuterine walls 28, 3t and 32. In this position, pessary 10 is disposed sothat the end of shank l2 remote from end 15, protrudes slightly at thevertical opening 34 at the outer ring of the cervix 36, as shown in FIG.3.

Each element 14 is disposed such that outer, convex surfaces 24 and 25of extensions 18 and portions 17 respectively are in relatively closeproximity to or in engagement with the proximal walls 28 and 30-32. Forinstance, each extension 13 is disposed with its surface 24 intengential engagement with wall 28. Similarly, each por tion 17 isdisposed with its surface 25 in tengential engagement with correspondingwalls 3t) and 32. The interengagement of elements 14 with walls 28, 3t)and 32 provides a substantial support for such walls so as to maintainthe normal shape of cavity 26. Moreover, elements 14 are disposed withincavity 26 so as to substantially block the path of ovum directed intocavity 26 from the Fallopian tubes 38 at the normal extremities ofcavity 26. This is apparent since surfaces 24 and 25 tengentially engagerespective walls 28, 3t and 32.

Each terminus 2% is disposed inwardly of surface 25, outwardly of arm 16and downwardly of surface 24, preferably spaced from the inner surfaceof the coil segment which constitutes element 14.

It has been found that even if elements 14 do not completely block thepath of ovum passing from tubes 38, pessary It) prevents theimplantation of the ovum on the uterine walls 28, 3t and 32. This isbelieved due to a stimulated foreign body reaction. Such reaction causesno substantial tissue changes in the walls themselves and, therefore,the same can be considered a benign condition.

Means for inserting pessary 10 within cavity 26 includes a tube 49having a pair of open ends 42 and 44 and provided with a plunger 46movable into and out of tube 40 at end 44 thereof. Pessary is of such anature that elements 14 may assume straight and parallel configurationsas they are inserted into tube 40 at end 42. As shown in FIG. 1,pess'ary 10 is completely received within tube 40 wit-h the shank 12 ofpessary 10 being first received therein, the elements 14 thereuponbecoming unlooped into side-by-side, elongated members 27.

In use, tube 40 is extended through the cervix 36 and partially intocavity 26 as shown in FIG. 2. Plunger 46 is then urged into tube 40 andagainst shank 12 to force pessary 10 into cavity 2 6. As the member 27move out of tube 40 and into cavity 26, the elements 14 re-loop andresume their normal arcuate coil segments. Plunger 46 continues to forcethe pessary 10 out of tube 40 until surfaces 24- of extensions 18contact wall 28. Tube 40 is then retracted from within cervix 36 andpessary 10 assumes the disposition illustrated in FIG. 3.

The method of insertion of pessary 10 within cavity 26 results in aminimum of irritation since the pessary 10 automatically assumes thenormal configuration as the same emanates from tube 40. Also, tube 40may be of a material and of a construction to minimize any irritation tothe adjacent walls forming the cervix 36 as the tube is inserted andremoved therefrom.

To remove pessary 10 from cavity 26, an instrument 48 is utilized, thelatter including a resilient, tubular shank 50 having a sleeve 52secured thereto at one end thereof, and a finger engaging bar 54 at theopposite end thereof. A rod 56 of small diameter extends through and isshiftable within shank 50. One end of rod 56 is coupled to a pair ofresilient jaws 58 which are carried within sleeve 52 and normallydiverge as jaws 58 move out of sleeve 52. The opposite end of rod 56 iscoupled with a grasping ring 60, the latter being normally spaced frombar 54 by a bias spring 62. As ring 69 is urged toward bar 54, jaws 58move out of and project outwardly from sleeve 52.

To remove pessary 10 from cavity 26, instrument .8 is disposed with theouter end of sleeve 52 in relatively close proximity to the end of shank12 at opening 34. Ring 60 is then urged toward bar 54 to force jaws 58outwardly until the same surround the corresponding end of shank 12.laws 58 are then moved into position grasping shank 12, and shank 50 isthen shifted in a direction to draw pessary 10 out of cavity 25.

It is to be noted that as pessary 10 is drawn out of cavity 26, walls 39and 32 are of such rigidity as to cause elements 14 to unloop and assumethe straight configuration of members 27 as illustrated in FIG. 1. Thus,as elements 14 pass through the cervix 36, they will be in the nature ofsubstantially straight and parallel members 27. To this end, theextremities may be sufficiently rounded to minimize any irritation towalls and 32 and the wall forming cervix 36.

The present invention provides a pessary which may be inserted in andremoved from the uterus with a minimum of irritation to the walls of theuterus while at the same time providing means for substantially blockingthe Fallopian tubes leading to the uterus and for preventing anysubstantial implantation of ovum in the uterine cavity. The materialforming pessary 10 is of a nature such that pessary 10 does not erodethe uterine cavity so as to cause cramping and other complicationsassociated therewith.

Having thus described the invention, what is claimed as new and desiredto be secured by Letters Patent is:

1. An infra-uterine pessary comprising:

a shank having a pair of oppositely looped elements on the upper endthereof,

said elements having upwardly-extending arms converging as said end ofthe shank is approached,

said arms having extensions thereon projecting outwardly in oppositedirections,

each of said extensions having a portion extending downwardly therefrom,

each of said portions having an inwardly-extending length thereon,

the extensions and the portions each having an outer,

uterus-engaging surface, each of said lengths having a terminus disposedinwardly of said surface of the corresponding portion, outwardly of thecorresponding arm, and downwardly of said surface of the correspondingexten- :sion,

said elements being of resilient, self-sustaining material,

permitting the same to be unlooped into side-byside, elongated membersextending upwardly from said end of the shank, and thereafter, inresponse to the memory of said material, to re-loop upon release of saidmembers from the upwardly-extending condition thereof.

2. The invention of claim 1, said surfaces being convex.

3. The invention of claim 1, said extension and portion of each elementcomprising an arcuate coil segment and said arm of each element beingdisposed tangentially to the extension thereof.

4. The invention of claim 1, said extension, said portion and saidlength of each element comprising an arcuate coil segment and said armof each element being upwardly bowed and disposed tangentially to theextension thereof.

References Cited by the Examiner UNITED STATES PATENTS 662,716 11/1900Gaedeke 128-130 709,675 9/1902 Holloweg 128-130 1,982,001 11/1934 Haas128130 2,122,579 7/1938 Meckstroth l28130 3,077,879 2/1963 Knoch 128-130RICHARD A. GAUDET, Prinmry Examiner.

DALTON L. TRULUCK, Examiner.

1. AN INTRA-UTERINE PESSARY COMPRISING: A SHANK HAVING A PAIR OFOPPOSITELY LOOPED ELEMENTS ON THE UPPER END THEREOF, SAID ELEMENTSHAVING UPWARDLY-EXTENDING ARMS CONVERGING AS SAID END OF THE SHANK ISAPPROACHED, SAID ARMS HAVING EXTENSIONS THEREON PROJECTING OUTWARDLY INOPPOSITE DIRECTIONS, EACH OF SAID EXTENSIONS HAVING A PORTION EXTENDINGDOWNWARDLY THEREFROM, EACH OF SAID PORTIONS HAVING AN WARDLY-EXTENDINGLENGTH THEREON, THE EXTENSIONS AND THE PORTIONS EACH HAVING AN OUTER,UTERUS-ENGAGING SURFACE, EACH OF SAID LENGTHS HAVING A TERMINUS DISPOSEDINWARDLY OF SAID SURFACE OF THE CORRESPONDING PORTION, OUTWARDLY OF THECORRESPONDING ARM, AND DOWNWARDLY OF THE SURFACE OF THE CORRESPONDINGEXTENSION, SAID ELEMENTS BEING OF RESILIENT, SELF-SUSTAINING MATERIALPERMITTING THE SAME TO BE UNLOOPED INTO SIDE-BYSIDE, ELONGATED MEMBERSEXTENDING UPWARDLY FROM SAID END OF SHANK, AND THEREAFTER, IN RESPONSETO THE MEMORY OF SAID MATERIAL, TO RE-LOOP UPON RELEASE OF SAID MEMBERSFROM THE UPWARDLY-EXTENDING CONDITION THEREOF.